No abstract available.
Fractures, Open*

OBJECTIVE: To investigate the relationship between urinary retention and short-term functional recovery in subacute stage after stroke. METHODS: The medical records of 94 patients admitted to the rehabilitation unit of Korea University Guro Hospital were reviewed retrospectively. The postvoid residual urine (PVR) was measured at least once a day using a bladder scan, and urinary retention (UR) was defined when the daily PVR volume consistently checked more than 100 mL. Clinical data and functional outcomes of patients in the rehabilitation ward were collected. Functional outcomes were measured using the Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS), Functional Ambulation Category (FAC) level, Fugl-Meyer Assessment (FMA), and Modified Barthel Index (MBI) at admission (or transfer) and discharge. The data of patients with and without urinary retention were compared and analyzed. RESULTS: Of the 94 participants, 25 patients were classified to the UR group and 69 were classified to the non-UR group. At the initial stage of rehabilitation, the scores of MMSE, BBS, FAC, MBI were significantly worse in the UR group (p<0.05). Both groups showed significant improvements of all functional outcomes after rehabilitation (p<0.05). The non-UR group showed more prominent recovery of BBS, FAC, MBI scores (p<0.05). CONCLUSION: Urinary retention in post-stroke patients is significantly related to the poor functional status at initial stage of rehabilitation, and also to poor recovery after rehabilitation.
Humans ; Korea ; Medical Records ; Rehabilitation* ; Retrospective Studies ; Stroke* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Retention* ; Walking

PURPOSE: Phyllodes tumor is a rare fibroepithelial disease of the breast that is classified as benign, borderline malignant, or malignant according to the pathological characteristics. To clarify diagnostic criteria for these groups, we analyzed the clinico-pathological characteristics of phyllodes tumors and the risk factors for local recurrence after surgery. METHODS: Between January 1997 and March 2003, we included 70 cases of recurring, pathologically-confirmed phyllodes tumors after surgery. Medical records were reviewed retrospectively for clinical characteristics and pathologic findings. RESULTS: The mean follow up period was 69.3 months (range 45.4 to 119.3 months) and mean age, 39.4 years old (range 18 to 63 years old). Benign phyllodes tumors were present in 45 cases (64.3%), borderline malignant tumors in 15 cases (21.4%), and malignant tumors in 10 cases (14.3%). A local recurrence developed in 9 cases (12.9%), with three of these cases benign (33.3%), 5 cases were borderline malignant (55.6%), and 1 case was malignant (11.1%). Borderline malignant cases showed a higher local recurrent rate (6.7%, 33.3%, and 10.0%, P=0.027). The local recurrence rate between the tumor-positive or close (<1 mm) resection margins and non-involved cases was different for benign (7.7% vs. 6.3%, P=0.031) and borderline malignant cases (60.0% vs. 20.0%, ns). CONCLUSION: Pathologic classification and small resection margins are risk factors for local recurrence in phyllodes tumors. Therefore, borderline malignant phyllodes tumors require wide excision with a sufficient resection margin or a mastectomy to prevent local recurrence.
Breast ; Follow-Up Studies ; Mastectomy ; Medical Records ; Phyllodes Tumor ; Recurrence ; Retrospective Studies ; Risk Factors

Jugular bulb diverticulum (JBD) is a rarely reported vascular anomaly, which is an extraluminal outpouching from the jugular bulb. Especially, there exists a lack of reported cases involving JBD encroaching the internal auditory canal (IAC) in Korea. Subjects with JBD may be asymptomatic or have variable symptoms based on its location and size. In this article, we report a unique case of JBD eroding into the IAC that was presented as sudden sensorineural hearing loss with vertigo.
Cytochrome P-450 CYP1A1 ; Diverticulum ; Hearing Loss ; Hearing Loss, Sensorineural ; Korea ; Vertigo

No abstract available.
Hair* ; Hypopigmentation* ; Scalp* ; Ureter*

Myotonic dystrophy is the most common autosomal dominant myopathy in adults. Our patient, a 41 year-old female suffering from myotonic muscular dystrophy, developed upper thoracic myelopathy due to hypertrophy of the ligamentum flavum and the posterior longitudinal ligament. She had a typical hatchet face and ptosis with "head hanging forward" appearance caused by neck weakness. Motor weakness, sensory changes and severe pain below T4 level, along with urinary incontinence began 3 months ago. Genetic and electrodiagnostic studies revealed myotonic dystrophy type 1. Magnetic resonance imaging of the spine showed loss of cervical lordosis and spinal cord compression due to hypertrophied ligamentum flavum and posterior longitudinal ligament at T1 to T3 level. We concluded that her upper thoracic myelopathy was likely related to the thickness of the ligamentum flavum and posterior longitudinal ligament due to repetitive mechanical stress on her neck caused by neck muscle weakness with myotonic dystrophy.
Adult ; Animals ; Female ; Humans ; Hypertrophy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lordosis ; Magnetic Resonance Imaging ; Muscular Diseases ; Muscular Dystrophies ; Myotonic Dystrophy ; Neck ; Neck Muscles ; Spinal Cord Compression ; Spinal Cord Diseases ; Spine ; Stress, Mechanical ; Stress, Psychological ; Urinary Incontinence

OBJECTIVE: To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder. METHODS: A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm-guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention. RESULTS: The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05). CONCLUSION: These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion.
Adhesives* ; Arthrography* ; Bursitis* ; Female ; Humans ; Range of Motion, Articular ; Shoulder Joint ; Shoulder Pain ; Shoulder*

PURPOSE: Axillary lymph node metastasis is one of the most important prognostic factors in breast cancer. Previous reports show differences that clinicopathologic factors influence the systemic recurrence and survival in axillary lymph node negative breast cancer. Thus, we have attempted to determine the prognostic factors influence on the systemic recurrence and survival in axillary lymph node negative breast cancer. METHODS: We retrospectively reviewed the data of 1,351 node negative breast cancer patients who underwent curative surgery to determine the prognostic factors such as age, sex, body mass index (BMI), family history, bilateral breast cancer, operation method, tumor size, stage, histologic grade, number of resected lymph nodes, hormone receptor status, overexpression of p53 and c-erbB2, and adjuvant therapy that influence the systemic recurrence and 10-year-distant relapse-free survival. RESULTS: Systemic recurrence occurred in 58 patients (4.3%) during 53.3 months median follow up period. The tumor size (P=0.001), stage (P=0.005), histologic grade (P=0.049). ER (P=0.028), PR (P=0.002), overexpression of p53 (P=0.001) and bilateral breast cancer (P=0.043) were statistically significant factors that influenced the systemic recurrence. In multivariate analysis, only tumor size was associated with the systemic recurrence (P=0.003). Tumor size (P=0.004), histologic grade (P=0.035), ER (P=0.046), PR (P=0.001) and bilateral cancer (P=0.003) were statistically significant factors that influenced 10-year-distant relapse-free survival. CONCLUSION: The larger tumor size was determined to be an independent prognostic value in axillary lymph node negative breast cancer.
Body Mass Index ; Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies

PURPOSE: This study was performed to show the several clinical variables before and after the surgery that need to be considered for patient selection and whether there is an increased possibility of recurrence after surgery and whether this possibility can be reduced when adjuvant treatment is applied. METHODS: The outcome of SSM with immediate breast reconstruction, using follow-up data of cases performed at Asan Medical Center between September, 1996 and December, 2002, were retrospectively assessed and pathologically advanced breast cancer patients (stage III) were analyzed separately. RESULTS: 191 patients had undergone SSM with immediate reconstruction during the study period. The percentage of cases stage III was 15.2% (29 cases). Among these patients, 6 (20.7%) were suspected of being in the early stages of breast cancer prior to the surgery. The mean age of the advanced breast cancer patients was 37 years. Immediate breast reconstruction consisted of a pedicled TRAM flap (n=24), a insertion of tissue expander (n=4) or direct implant (n=1). Radiotherapy was performed in 16 patients (53.3%) and chemotherapy was conducted without delay in all case. With a median length of follow-up of 36.1 months for 22 patients, who under went the operation until December, 2001, local recurrence was 4.5% (1/22) with successful local treatment, and distant metastasis was 13.7% (3/22). There was no difference in the disease free survival compared to that of the non-reconstruction group (P=0.093). CONCLUSION: SSM with immediate reconstruction seems safe and effective for patients with advanced breast cancer. However an accurate preoperative assessment of the extent of the disease and discussion for the planning of treatment between surgeon and patient is required.
Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy* ; Neoplasm Metastasis ; Patient Selection ; Radiotherapy ; Recurrence ; Retrospective Studies ; Tissue Expansion Devices

The interlocking nail is used as a valuable method in treating humerus shaft fracture because of the merit, including relatively simple procedure, one of the most stable fixation methods, and allowing early ROM excericise and low complication. Fourteen pateints with humerus shaft fractures were treated using interlocking nail at the Department of Orthopaedic Surgery Paik Hospital from Jan.1993 to Oct.1994. l. Among the 14 pateints, average age was 34.8 years and 9 cases were male and the most common cause of injury was traffic accident. 2. Associated injury including 3 cases of ipsilateral scapular fracture, I case of ipsilateral clavicle fracture, and 1 case of brachial plexus injury, and 1 case of radial nerve injury. 3. The mean duration of the radiologic bone union was 8.6 weeks. 4. There was no serious post operative complication such as non-union, infection, bending or rotational deformity at fracture site, impingement syndrome, metal failure of the nail or interlocking screws. 5. To prevent the impingement syndrom and rotator cuff injury, we countersinked the proximal end of the nail into the humeral head and minimized skin incision.
Accidents, Traffic ; Brachial Plexus ; Clavicle ; Congenital Abnormalities ; Humans ; Humeral Head ; Humerus ; Male ; Methods ; Radial Nerve ; Rotator Cuff ; Skin ; Tibia